Over schildklierziekte en zwangerschap
Een nieuw artikel over schildklierziektes en zwangerschap.
Thyroid disease in pregnancy: new insights in diagnosis and clinical management
Tim Korevaar, Marco Medici, Theo Visser en Robin Peeters
- Studies published during the past decade have enabled researchers to gain new insights into the diagnosis, physiology and treatment of thyroid disease during pregnancy.
- The previously recommended TSH cut-offs of 2.5 mU/l or 3.0 mU/l are too low and are likely to lead to overdiagnosis and overtreatment of thyroid disease during pregnancy.
- The combination of thyroid peroxidase-antibody positivity and a high concentration of TSH seems to synergistically increase the risk of adverse pregnancy outcomes.
- Substantial new evidence supports the important role of thyroid hormone for fetal neurodevelopment.
- New studies indicate that in patients treated with levothyroxine, titration to thyroid hormone concentrations in the higher end of the normal range might carry a risk of overtreatment.
- Particularly during early pregnancy, treatment with methimazole (thiamazole) or propylthiouracil might increase the risk of fetal anomalies, and clinicians should consider the cessation of low-dose regimens.